Oncologist Gautam Mukhopadhyay said, "The number of survivors has been declining. This ought to be linked to poor symptom recognition in the early stages. While some forms of the disease like lung, liver, gall bladder or uterine cancers are difficult to spot, physicians should not take chances. They must remember that time is a huge factor in cancer treatment and a few weeks could spell the difference between life and death."

A cancerous tumour could grow 4cm in four months, pointed out Diptendra Sarkar, head of the department of breast cancer at IPGMER. "A 2cm-long malignant tumour could grow to 6cm in four months. While the former is treatable, the latter could lead to death in less than two years. In scores of cases, particularly upper stomach region cancer, patients are misguided by physicians. Where a simple test could have revealed the disease, the latter prescribe medicines without making any attempt to detect the cause. It's only when drugs fail that specialist opinion is sought. But it's often too late by then," he explained.

"Early indications of cancer include a painless lump, white patches in the mouth, a growing mole, sudden change in bowel habits, unexplained loss of apetite and bleeding from orifices. These are typical early signs of cancer which are common to multiple diseases. But they shouldn't be ignored. Strangely, while diagnostic methods have improved, there's a tendency to defer them which is turning out to be fatal in a large number of cases," said oncologist Subir Ganguly.

He cited lung and intestinal as the two forms of cancer that were detected late in Kolkata. "While the initial symptoms of the former were similar to breathing disorder, the latter was akin to chronic indigestion. That apart, patients were often loathe to seek specialized opinion and went into a denial mode even after the signs became clear," he said.

Deficiencies in the MBBS curriculum were responsible for failing to make physicians more cautious about cancer, felt experts. "We need a re-orientation of the course with more stress on cancer recognition. At present, the syllabus is a sketchy one and doesn't train adequately," said Sarkar. Oncology lacks focus in undergraduate medical courses, felt Ganguly. "It isn't given due importance which is unfortunate. Also, we should have a hands-on component in the course which is now absent," added Ganguly.

Thousands of cancer patients in the city either rely on self-medication or take non-disease specific medicines during the first two months. "This is where we are losing the battle. Once the cancer cells proliferate, we are left playing a catching-up game and the chances of survival fall drastically," said Ganguly.

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A bench of Chief Justice Rajendra Menon and Justice V K Rao passed the order while acting on a PIL filed by Delhi-based dermatologist Zaheer Ahmed who complained that lakhs of medicines were being sold on the internet every day without much regulation, posing a huge risk to patients and doctors alike.